Laryngeal amyloidosis: a rare cause of hoarseness

Introduction.-The larynx is a rare site of deposition for amyloidosis. Diag nosis may be delayed and evoked in patients with prolonged hoarseness. We h ave reported two cases of laryngeal amyloidosis. Exegesis.-One man and one woman suffered from hoarseness during one and thr ee years, respectively. Laryngoscopic examination showed diffuse infiltrati on of the larynx. Amyloidosis was confirmed by the characteristic Congo-red staining of laryngeal biopsies. The search for other localizations of amyl oidosis was negative. No monoclonal plasma cell proliferation was detected. Both patients received endoscopic CO, laser excision, In one case, chemoth erapy was initially associated due to dystrophic plasma cells in bone marro w aspiration and then withdrawn because of clinical failure. With a 6-month follow-up, hoarseness remained stable. Conclusion.-Laryngeal amyloidosis is an essentially localized disease revea led by hoarseness. Treatment is endoscopic by laser excision. In nearly hal f of the cases in the literature, it had to be repeated due to localized re current lesions. Long-term prognosis of localized laryngeal amyloidosis is better than systemic AL amyloidosis. (C) 2000 Editions scientifiques et med icales Elsevier SAS.